ETA2023 Poster Presentations Treatment 1 (9 abstracts)
Role of preoperative serum calcitonin and carcinoembryonic antigen in predicting surgical extent of lateral lymph node metastasis in medullary thyroid carcinoma: a multicenter study in korea
Bohyun Kim 1 , Mijin Kim 2 , Won Gu Kim 3 , Dong Jun Lim 4 , Hee Kyung Kim 5 , Ho-Cheol Kang 5 , Byeong-Cheol Ahn 6 , Eun Sook Kim 7 , Won Bae Kim 3 & Young Kee Shong 3
1Biomedical Research Institute, Pusan National University Hospital, Department of Internal Medicine, Busan, Korea, Rep. of South; 2Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea; 3Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; 4Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.; 5Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.; 6Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.; 7Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
Background: The optimal initial surgical extent for medullary thyroid carcinoma (MTC) remains controversial. Aim of this study was to evaluate the ability of serum calcitonin and carcinoembryonic antigen(CEA) to predict the extent of surgery needed in the lateral neck in patients with MTC.
Methods: This retrospective multicenter cohort study included data from patients with MTC surgically treated in the 6 tertiary medical centers in Korea from 1996 to 2022. We retrospectively reviewed data on preoperative level of calcitonin and CEA, primary tumor size, and the number and location of lymph node metastases (LNMs) in 203 patients with MTC.
Results: Lateral LNMs and initial distant metastasis was present in 75 patients (36.9%) and 8 patients (3.9%), respectively. The preoperative level of calcitonin and CEA in patients with lateral LNMs was significantly higher than that of patients with central LNMs (median calcitonin 960 pg/mL vs 133.8 pg/ml, median CEA 41.8 ug/l vs 9.3 ug/l, P < 0.001). The cutoff value of preoperative calcitonin and CEA for prediction of lateral LNMs was 403 pg/mL and 9.5 ug/l, respectively. The area under the curve (AUC) of calcitonin and CEA for prediction of lateral LNMs were 0.773 (95% CI: 709–0.837, P < 0.001) and 0.747 (95% CI: 0.679-0.815, P < 0.001). In multivariate analysis, factors associated with lateral LNMs were gross extra-thyroidal extension (P = 0.002), calcitonin (≥ 50pg/mL) (P = 0.006), and CEA (≥ 10 mg/l) (P = 0.002)
Conclusions: The preoperative level of serum basal calcitonin and CEA were correlated with disease extent and showed significant value for predicting the extent of LNMs. These results suggest that both preoperative basal level of calcitonin and CEA can be used to determine the optimal initial surgical extent for LN dissection in patients with MTC.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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